Supplementary waiver for Study Abroad in Countries with Active Travel Warnings.

I ______(print name), acknowledge that I have been informed that there are heightened risks involved with travel to Israel and Palestine. I acknowledge that I have read and understood the Travel Warnings issued by the U.S. Department of State ( and that despite the risks I have decided to pursue my plans to participate in the Wooster in Israel and Palestine Program. I understand that such travel and activities carry certain inherent risks and dangers of bodily injury, death, and loss of personal property, and I acknowledge and accept the risks and dangers associated with the activity. I assume full responsibility for myself and my property during the activity and while traveling to and from the Study Abroad site.

I agree to hold college administrators and personnel connected to this activity, the director of the program, The College of Wooster, the Board of Trustees, officers, and employees harmless for any direct, indirect, special, or consequential damages which I may incur or be held liable for as a result of my participation in this activity, except to the extent that such damages are due to the negligence of any of the aforesaid persons or entities.

I understand that conditions in my destination country/ies may deteriorate rapidly and that I must stay informed of current events. I will submit to the Office of Off Campus Study all information necessary to register my arrival and departure with the US Embassy or Consulate in a timely manner. If I am not a US citizen I will also register with my home country’s Embassy or Consulate.

I affirm that I have obtained health insurance that will remain in effect while I am in Israel and Palestine.

I acknowledge that I have discussed my plans to travel to Israel and Palestine with at least one of my parents or guardians, and that person has also read and signed this form as indicated below.

I understand that this Supplementary Waiver for Study Abroad in Countries with Active Travel Warnings has been executed in conjunction with a separate Certification of Responsibility and Release of Liability form and supplements this form.

I have read this Supplementary Waiver for Study Abroad in Countries with Active Travel Warnings. I know, understand and appreciate these and other risks that are inherent in the Activity. I expressly agree and assert that participation in the Activity is voluntary and I knowingly assume all such risks and elect to proceed with the participation despite all the risks. I acknowledge that I have signed this Waiver and the Certification of Responsibility and Release of Liability form freely and voluntarily and intend, by my signature, the complete and unconditional release of all liability to the greatest extent allowed by law.

Date:
Student’s Signature

TO BE READ AND SIGNED BY A PARENT/GUARDIAN

I hereby represent that I am the parent or guardian of the student whose name appears above. I have read and consent and agree to the terms and provisions set forth in this Supplementary Waiver for Study Abroad in Countries with Active Travel Warnings on behalf of myself and said student.

Date:
Parent/Guardian’s Signature

Please return this form to Dr. Friedman, with your other application materials, by October 28, 2011 (class of 2012: October 21).

Off-Campus Studies ● Wooster OH 44691

Tel +1-330.263.2221 ● Fax +1-330.263.2076 ●